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https://www.readbyqxmd.com/read/29150995/efficacy-and-safety-of-extracranial-vein-angioplasty-in-multiple-sclerosis-a-randomized-clinical-trial
#1
Paolo Zamboni, Luigi Tesio, Stefania Galimberti, Luca Massacesi, Fabrizio Salvi, Roberto D'Alessandro, Patrizia Cenni, Roberto Galeotti, Donato Papini, Roberto D'Amico, Silvana Simi, Maria Grazia Valsecchi, Graziella Filippini
Importance: Chronic cerebrospinal venous insufficiency (CCSVI) is characterized by restricted venous outflow from the brain and spinal cord. Whether this condition is associated with multiple sclerosis (MS) and whether venous percutaneous transluminal angioplasty (PTA) is beneficial in persons with MS and CCSVI is controversial. Objective: To determine the efficacy and safety of venous PTA in patients with MS and CCSVI. Design, Setting, and Participants: We analyzed 177 patients with relapsing-remitting MS; 62 were ineligible, including 47 (26...
November 18, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/29150415/-initiating-hemodialysis-in-morocco-impact-of-late-referral
#2
Abdelaali Bahadi, Mohammed Reda El Farouki, Yassir Zajjari, Driss El Kabbaj
INTRODUCTION: End-stage renal disease (ESRD) is a major public health concern in Morocco with an incidence in constant progression according to MAGREDIAL "Morocco Dialysis Registry". Patients are often sent late to nephrologists, which is a source of complications recognized in several countries. For these reasons, we tried to evaluate, in our context, the prevalence and factors of this late referral (LR). METHODS: This is a retrospective study which included all patients initiating hemodialysis between January 2007 and December 2015...
November 14, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29149032/optimal-line-and-tube-placement-in-very-preterm-neonates-an-audit-of-practice
#3
Daragh Finn, Hannah Kinoshita, Vicki Livingstone, Eugene M Dempsey
BACKGROUND: Placement of endotracheal tubes (ETTs) and umbilical catheters (UCs) is essential in very preterm infant care. The aim of this study was to assess the effect of an educational initiative to optimize correct placement of ETTs and UCs in very preterm infants. METHODS: A pre-post study design, evaluating optimal radiological position of ETTs and UCs in the first 72 h of life in infants <32 weeks gestational age (GA) was performed. Baseline data was obtained from a preceding 34-month period...
November 17, 2017: Children
https://www.readbyqxmd.com/read/29148007/how-to-treat-arteriovenous-graft-infection-total-versus-partial-graft-excision
#4
Suh Min Kim, Seung-Kee Min, Sanghyun Ahn, Sang-Il Min, Jongwon Ha, Jung Kee Chung
INTRODUCTION: Arteriovenous graft (AVG) infection can result in life-threatening sepsis and loss of vascular access. A retrospective study was performed to establish an appropriate treatment strategy for AVG infection. METHODS: A total of 50 cases of AVG infection were treated between January 2005 and June 2016. The surgical methods used were total graft excision (TGE) (n = 34), or partial graft excision (PGE) with interposition graft (n = 16). RESULTS: Infection was noted at a puncture site (n = 22), a prior incision for surgery or endovascular therapy (n = 20), and abandoned (currently unused) grafts (n = 5)...
November 11, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29148001/an-arterioarterial-prosthetic-graft-as-an-alternative-option-for-haemodialysis-access-a-systematic-review
#5
Matthew J Grima, Bianca Vriens, Peter J Holt, Eric Chemla
INTRODUCTION: All arteriovenous fistula/grafts options should be exhausted before haemodialysis is carried out via central venous catheters (CVC). CVCs carry high morbidity and mortality risks and in some patients, the central veins could be exhausted. In these patients, an arterioarterial prosthetic loop (AAPL) or straight graft can be the only option for haemodialysis. A systematic review was thus carried out to look at the use of arterioarterial graft for haemodialysis, with regards to dialysis adequacy, complications, and patency rates...
November 10, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29148000/the-feasibility-and-safety-of-piccs-accessed-via-the-superficial-femoral-vein-in-patients-with-superior-vena-cava-syndrome
#6
Yonghui Wan, Yuxin Chu, Yanru Qiu, Qian Chen, Wei Zhou, Qibin Song
OBJECTIVE: To investigate the feasibility and safety of the peripherally inserted central catheters (PICCs) accessed via the superficial femoral vein in patients with superior vena cava syndrome (SVCS). METHODS: From October 2010 to December 2014, 221 cancer patients with SVCS in our center received real-time ultrasound-guidance of the superficial femoral vein inserted central catheters (FICCs) at the mid-thigh. PICC insertion via upper extremity veins had also been investigated in 2604 cancer patients without SVCS as control...
November 10, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29142959/hemodialysis-infection-prevention-protocols-ontario-shower-technique-hippo-st-a-pilot-randomized-trial
#7
S Daisy Kosa, Amiram Gafni, Andrew A House, JulieAnn Lawrence, Louise Moist, Bharat Nathoo, Paul Tam, Alicia Sarabia, Lehana Thabane, George Wu, Charmaine E Lok
Introduction: We developed the Hemodialysis Infection Prevention Protocols Ontario-Shower Technique (HIPPO-ST) to permit hemodialysis (HD) patients with central venous catheters (catheters) to shower without additional infection risk. Our primary objective was to determine the feasibility of conducting a parallel randomized controlled trial (RCT) to evaluate the impact of HIPPO-ST on catheter-related bacteremia (CRB) in adult HD patients. Methods: Adult HD patients using catheters were recruited from 11 HD units...
March 2017: KI Reports
https://www.readbyqxmd.com/read/29142756/usefulness-of-central-venous-saturation-as-a-predictor-of-thiamine-deficiency-in-critically-ill-patients-a-case-report
#8
Genri Numata, Satoshi Kodera, Hiroyuki Kiriyama, Atsuko Nakayama, Eisuke Amiya, Arihiro Kiyosue, Masaru Hatano, Eiki Takimoto, Masafumi Watanabe, Issei Komuro
Background: Central venous oxygen saturation (ScvO2) reflects the balance of oxygen delivery and consumption. Low ScvO2 indicates the presence of inadequate oxygen delivery, while high ScvO2 indicates reduced oxygen consumption and is sometimes associated with a high mortality rate in critically ill patients from dysoxia. Thiamine is an essential cofactor in cellular aerobic metabolism. Thiamine deficiency is more prevalent than was previously thought, and underlies severe conditions in critically ill patients...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/29142743/anti-candida-activity-of-antimicrobial-impregnated-central-venous-catheters
#9
L Cobrado, A Silva-Dias, M M Azevedo, A Rodrigues
Background: Whenever the rate of central line-associated bloodstream infections (CLABSIs) remains high even after the implementation of preventive strategies, the use of chlorhexidine/silver sulfadiazine (CSS) or minocycline/rifampin (MR)-impregnated central venous catheters (CVCs) is currently recommended. Nevertheless, the efficacy of such CVCs against Candida albicans and other emerging non-albicans spp. has been insufficiently studied. This study aims to compare the activity of CSS and MR-impregnated CVCs against the yeasts most frequently isolated from CLABSIs...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/29141527/decreases-in-mixed-venous-blood-o2-saturation-in-cardiac-surgery-patients-following-extubation
#10
Jeffrey Williams, Anna McLean, Jalil Ahari, Arun Jose, Georges Al-Helou, Italo Ibi, Farzad Najam Md, Guillermo Gutierrez
BACKGROUND: Decreases in mixed venous O2 saturation (SvO2) have been reported to occur in postcardiac surgery patients during weaning from mechanical ventilation. Our aim was to establish whether the physiological mechanism responsible for this phenomenon was a decrease in systemic O2 delivery (DO2) or an increase in global O2 consumption ([Formula: see text]O2). METHODS: We studied 21 mechanically ventilated, postoperative cardiac patients for 30 minutes before and 60 minutes after extubation...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29138677/oxidative-stress-in-hemodialysis-patients-a-review-of-the-literature
#11
REVIEW
Vassilios Liakopoulos, Stefanos Roumeliotis, Xenia Gorny, Evangelia Dounousi, Peter R Mertens
Hemodialysis (HD) patients are at high risk for all-cause mortality and cardiovascular events. In addition to traditional risk factors, excessive oxidative stress (OS) and chronic inflammation emerge as novel and major contributors to accelerated atherosclerosis and elevated mortality. OS is defined as the imbalance between antioxidant defense mechanisms and oxidant products, the latter overwhelming the former. OS appears in early stages of chronic kidney disease (CKD), advances along with worsening of renal failure, and is further exacerbated by the HD process per se...
2017: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/29137915/first-line-direct-access-for-transarterial-embolization-of-a-dural-arteriovenous-fistula-case-report-and-literature-review
#12
Brent J Doolan, Iddo Paldor, Peter J Mitchell, Andrew P Morokoff
Intracranial dural arteriovenous fistulae (DAVF) are complex vascular malformations consisting of a pathological shunt located between meningeal arteries and drainage to dural venous sinuses and/or cerebral veins. We report an unusual anatomical variation, resulting in a DAVF forming between the superior sagittal sinus and an anomalous origin of the middle meningeal artery (MMA) arising from the left ophthalmic artery. We present an atypical case requiring mini-craniotomy for catheter access, as well as cannulation of extracranial arterial supply prior to embolization of a Cognard type IIa+b fistula...
November 11, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29137910/tamponade-hemodynamic-and-echocardiographic-diagnosis
#13
REVIEW
Mark J Kearns, Keith R Walley
Cardiac tamponade is a medical emergency that can be readily reversed with timely recognition and appropriate intervention. The clinical diagnosis of cardiac tamponade requires synthesis of a constellation of otherwise non-specific features, based on an understanding of the underlying pathophysiology. Whereas echocardiographic examination is a central component of diagnosis, alone it is insufficient to establish the physiologic diagnosis of hemodynamically significant cardiac tamponade. The hemodynamic diagnosis of cardiac tamponade requires clinical evidence of low cardiac output and stroke volume in the setting of elevated cardiac filling pressures, with evidence of increased sympathetic tone (tachycardia, peripheral vasoconstriction, etc), and exclusion of other causes of shock as the primary problem (particularly cardiogenic shock)...
November 11, 2017: Chest
https://www.readbyqxmd.com/read/29137701/the-correlation-between-atls-and-junior-doctors-anatomical-knowledge-of-central-venous-catheter-insertion-at-a-major-trauma-service-in-south-africa
#14
V Y Kong, J J Odendaal, R Weale, M Liu, C M Keene, B Sartorius, D L Clarke
OBJECTIVE: To review the ability of junior doctors (JDs) in identifying the correct anatomical site for central venous catheterization (CVC) and whether prior Advanced Trauma Life Support (ATLS) training influences this. DESIGN: We performed a prospective, observational study using a structured survey and asked a group of JDs (postgraduate year 1 [PGY1] or year 2 [PGY2]) to indicate on a photograph the exact site for CVC insertion via the internal jugular (IJV) and the subclavian (SCV) approach...
November 7, 2017: Injury
https://www.readbyqxmd.com/read/29135819/prophylactic-rtpa-in-the-prevention-of-line-associated-thrombosis-and-infection-in-short-bowel-syndrome
#15
Lynn M Malec, James Cooper, Jeffrey Rudolph, Marian G Michaels, Margaret V Ragni
BACKGROUND: Central venous access devices (CVADs) are essential for total parenteral nutrition administration in patients with short bowel syndrome (SBS). However, they are fraught with complications including infection and venous thromboembolism (VTE), which increases associated morbidity and mortality in this population. There is evidence linking the development of CVAD-associated thrombosis and line-related infection. Thus, it has been postulated that prevention of catheter-related clot formation could minimize the risk of infection originating from the catheter...
November 10, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29135593/ultrasound-guided-dynamic-needle-tip-positioning-technique-versus-palpation-technique-for-radial-arterial-cannulation-in-adult-surgical-patients-a-randomized-controlled-trial
#16
Roy K Kiberenge, Kenichi Ueda, Brett Rosauer
BACKGROUND: Radial arterial cannulation is most commonly done using palpation, but the use of ultrasound has increased the cannulation success rate. This improvement, albeit significant, has not led to a very high success rate especially in trainees. A modified ultrasound technique for vascular cannulation (dynamic needle tip positioning) has been described for peripheral venous cannulation. We therefore assessed the success rate of this technique compared to the palpation technique for radial artery cannulation in adult surgical patients...
November 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29133157/microbiological-and-clinical-characteristics-of-biofilm-forming-candida-parapsilosis-isolates-associated-with-fungaemia-and-their-impact-on-mortality
#17
Silvia Soldini, Brunella Posteraro, Antonietta Vella, Elena De Carolis, Elisa Borghi, Monica Falleni, Angela Raffaella Losito, Giuseppe Maiuro, Enrico Maria Trecarichi, Maurizio Sanguinetti, Mario Tumbarello
OBJECTIVES: Biofilm formation (BF) by fungal isolates may dramatically complicate infection. We determined the ability of C. parapsilosis isolates from single fungaemia episodes to form biofilms and we analysed biofilm subgroups for antifungal susceptibility and pathogenic potential. We then correlated BF with clinical characteristics and outcomes of the episodes. METHODS: BF was measured using the crystal-violet biomass assay, antifungal susceptibility of preformed biofilms was assessed, and virulence was studied using the Galleria mellonella model...
November 10, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29132220/catheter-directed-thrombolysis-versus-standard-anticoagulation-for-acute-lower-extremity-deep-vein-thrombosis-a-meta-analysis-of-clinical-trials
#18
Yongming Lu, Linyi Chen, Jinhui Chen, Tao Tang
Standard anticoagulant treatment alone for acute lower extremity deep vein thrombosis (DVT) is ineffective in eliminating thrombus from the deep venous system, with many patients developing postthrombotic syndrome (PTS). Because catheter-directed thrombolysis (CDT) can dissolve the clot, reducing the development of PTS in iliofemoral or femoropopliteal DVT. This meta-analysis compares CDT plus anticoagulation versus standard anticoagulation for acute iliofemoral or femoropopliteal DVT. Ten trials were included in the meta-analysis...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29132056/central-venous-pressure-and-ultrasonographic-measurement-correlation-and-their-associations-with-intradialytic-adverse-events-in-hospitalized-patients-a-prospective-observational-study
#19
Hiroshi Sekiguchi, Luke A Seaburg, Jun Suzuki, Walter J Astorne, Anil S Patel, A Scott Keller, Ognjen Gajic, Kianoush B Kashani
PURPOSE: To investigate correlation of central venous pressure (CVP) with ultrasonographic measurement of central veins, along with association between these variables and occurrence of intradialytic adverse events in hospitalized patients. MATERIALS AND METHODS: Patients requiring hemodialysis via dialysis catheter were prospectively enrolled. CVP measurements through catheter, internal jugular vein aspect ratio, subclavian vein collapsibility, inferior vena cava (IVC) maximal diameter, and IVC collapsibility were recorded before and after hemodialysis...
October 29, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29128346/mortality-risk-factors-among-non-icu-patients-with-nosocomial-vascular-catheter-related-bloodstream-infections-a-prospective-cohort-study
#20
Patrick Saliba, Ana Hornero, Guillermo Cuervo, Immaculada Grau, Emilio Jimenez, Dolors García, Fe Tubau, Jose María Martínez-Sánchez, Jordi Carratalà, Miquel Pujol
BACKGROUND: Vascular catheter-related bloodstream infections (CRBSIs) are highly preventable hospital-acquired infections and a major threat to patient safety. While there is significant information regarding CRBSI outcome among Intensive Care Unit (ICU) patients, data regarding non-ICU patients are scarce. AIM: To determine the risk factors associated with 30-day mortality among non-ICU patients with nosocomial CRBSIs. METHODS: Prospective cohort study of non-ICU patients with nosocomial CRBSIs in a tertiary-care centre, between January 2004 and December 2014...
November 8, 2017: Journal of Hospital Infection
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